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What is the key question?
COPD patients are at high risk of major cardiovascular (CV) events. Several non-invasive CV risk markers have been proposed to predict these events in the general population but never been compared in COPD patients.
What is the bottom line?
Coronary Artery Calcium (CAC) is the best non-invasive CV risk marker that predicts major CV events in this population of COPD patients.
Why read on?
The incorporation of this tool into daily practice of practitioners caring for patients with COPD could help detect high risk patients for future major CV events.
Background
Chronic Obstructive Pulmonary Disease (COPD) and cardiovascular disease (CV) are two of the leading causes of death in the world [1]. Several studies have demonstrated the close relationship between COPD and CV disease [2, 3]. Patients suffering from coronary artery disease (CAD) that also have COPD, double the risk of death from CV disease compared to patients without COPD [3]. On the other hand, patients with COPD are at greater risk of morbidity and mortality from CV disease [4, 5]. According to several studies CV deaths are amongst the major causes of death in patients with COPD especially in those with mild to moderate degree of airway obstruction [6-9].
Although the recent update of the COPD GOLD guidelines recommend an evaluation for the presence of associated comorbidities [10], they do not specify how to evaluate pre-symptomatic patients through the use of non-invasive tools. The guidelines only state that clinicians should use the same methodology used in patients without the disease, but the potential use of non-invasive tools in the evaluation of future risk for CV events in these patients has not been investigated. A recent systematic review and meta-analysis [11] highlighted the need for the development of strategies to screen for CV risk factors in patients with COPD.
In order to help clinicians caring for COPD patients better detect risk of future CV events, we decided to evaluate the ability of different non-invasive tools in predicting cardiovascular events in a population of real-life patients with COPD attending pulmonary clinics.
Methods
Participants were former and current smokers of at least 10 pack-years with previous spirometric diagnosis of COPD and regularly seen in our pulmonary clinic. All patients signed the consent...